MEDICARE: DR. ADRIENNE VICTORIA SAMPSON PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	P.07752	OH

General Provider Information

NPI Number	:	1942780101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ADRIENNE VICTORIA SAMPSON PHD

Provider Business Mailing Address
First Line	:	3867 W MARKET ST # 204
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333-4525
Country	:	US
Telephone Number	:	330-427-8545
Fax Number	:

Provider Business Practice Location Address
First Line	:	3867 W MARKET ST # 204
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44333-4525
Country	:	US
Telephone Number	:	330-427-8545
Fax Number	:	330-427-8331

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2018
Last Update Date	:	04/18/2024

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